<p>The first autopsy of a 61-year-old Covid-19 victim in Bengaluru, conducted 16 to 18 hours after death, has shown that the virus was absent on the skin surface but was present in the nose, mouth and throat.</p>.<p>Conducted by Dr Dinesh Rao, Head of Department, Forensic Medicine, Oxford Medical College, the autopsy sought to find the virus’ presence in the dead body, understanding the way the disease progresses and its outcome.</p>.<p class="CrossHead"><strong>Five swabs, five results </strong></p>.<p>The RT-PCR test of five swabs taken from different parts of the body revealed different results.</p>.<p>While one swab was taken from the nose, the others were taken from the mouth, throat, lung surface, respiratory passages (bronchi and the trachea) and from the skin surface (face and the neck).</p>.<p>“After my examination, what I shockingly found was the virus was still present in the nose, mouth and throat,” Dr Rao said.</p>.<p>Asked about the fear among people who object to burying Covid victims in their locality, Dr Rao said new rules are needed based on scientific data.</p>.<p>“It is high time we stop following what the ICMR or WHO says. We should conduct our own research. ICMR policies say we should not touch the body. But when asked why, they say the WHO says so. What prevents them from conducting such a study? My study concludes that there was no virus present on the face and the neck, then why can’t we touch the body?” </p>.<p>He said “a series of studies” must be conducted to find out how long the virus will last, and frame policies based on the findings on touching the Covid patient’s dead body.</p>.<p class="CrossHead"><strong>Lungs like a leather ball </strong></p>.<p>Examination of the lungs, heart, kidneys, brain, spleen, and liver showed that the lungs, which usually have a spongy appearance, looked like a hard leather ball in the Covid-19 patient.</p>.<p>“This is an important finding. What we term a ‘shock lung’ is a severely damaged lung, enlarged in size and firm,” Dr Rao said.</p>.<p>“But the Covid-19 patient’s lung was not enlarged. It was the usual size, but firm. Sections of alveoli or air sacs were ruptured. There was also interstitial pneumonia and inflammatory cells. Multiple emboli or blood clots were also found in the blood vessels due to which there was coagulative necrosis of the lungs.”</p>.<p class="CrossHead"><strong>Treatment regime</strong></p>.<p>The findings also offer an insight into the treatment regime.</p>.<p>“If we connect such patients to a ventilator and give antibodies, they are going to die. The basic underlying pathology is a thromboembolic phenomenon, which needs to be treated first, only then can oxygen therapy must be administered. These should go together. Failing to give thrombolytic therapy will kill the patient,” Dr Rao said.</p>
<p>The first autopsy of a 61-year-old Covid-19 victim in Bengaluru, conducted 16 to 18 hours after death, has shown that the virus was absent on the skin surface but was present in the nose, mouth and throat.</p>.<p>Conducted by Dr Dinesh Rao, Head of Department, Forensic Medicine, Oxford Medical College, the autopsy sought to find the virus’ presence in the dead body, understanding the way the disease progresses and its outcome.</p>.<p class="CrossHead"><strong>Five swabs, five results </strong></p>.<p>The RT-PCR test of five swabs taken from different parts of the body revealed different results.</p>.<p>While one swab was taken from the nose, the others were taken from the mouth, throat, lung surface, respiratory passages (bronchi and the trachea) and from the skin surface (face and the neck).</p>.<p>“After my examination, what I shockingly found was the virus was still present in the nose, mouth and throat,” Dr Rao said.</p>.<p>Asked about the fear among people who object to burying Covid victims in their locality, Dr Rao said new rules are needed based on scientific data.</p>.<p>“It is high time we stop following what the ICMR or WHO says. We should conduct our own research. ICMR policies say we should not touch the body. But when asked why, they say the WHO says so. What prevents them from conducting such a study? My study concludes that there was no virus present on the face and the neck, then why can’t we touch the body?” </p>.<p>He said “a series of studies” must be conducted to find out how long the virus will last, and frame policies based on the findings on touching the Covid patient’s dead body.</p>.<p class="CrossHead"><strong>Lungs like a leather ball </strong></p>.<p>Examination of the lungs, heart, kidneys, brain, spleen, and liver showed that the lungs, which usually have a spongy appearance, looked like a hard leather ball in the Covid-19 patient.</p>.<p>“This is an important finding. What we term a ‘shock lung’ is a severely damaged lung, enlarged in size and firm,” Dr Rao said.</p>.<p>“But the Covid-19 patient’s lung was not enlarged. It was the usual size, but firm. Sections of alveoli or air sacs were ruptured. There was also interstitial pneumonia and inflammatory cells. Multiple emboli or blood clots were also found in the blood vessels due to which there was coagulative necrosis of the lungs.”</p>.<p class="CrossHead"><strong>Treatment regime</strong></p>.<p>The findings also offer an insight into the treatment regime.</p>.<p>“If we connect such patients to a ventilator and give antibodies, they are going to die. The basic underlying pathology is a thromboembolic phenomenon, which needs to be treated first, only then can oxygen therapy must be administered. These should go together. Failing to give thrombolytic therapy will kill the patient,” Dr Rao said.</p>
